Document Detail


Role of tissue Doppler and color M-mode imaging for evaluation of diastolic function in ambulatory patients with LV systolic dysfunction.
MedLine Citation:
PMID:  17456066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Tissue Doppler imaging (TDI) and color M-mode (CMM) indices provide assessment of left ventricular (LV) relaxation when combined with pulse-wave Doppler (PWD)-derived transmitral inflow, allows for estimation of LV filling pressures. However, use of these indices in patients with LV systolic dysfunction (LVSD) has not been well characterized.
METHODS AND RESULTS: The study included 115 patients (age 58 +/- 11 years, 67% male) with LVSD (LV ejection fraction [LVEF] < 55%). Patients were grouped according to the diastolic LV filling pressure assessed by E/Em(septal) ratio as follows: 1) Normal (NFP), E/Em(septal) < 8; 2) Intermediate (IFP), E/Em(septal): 8-15; and 3) High (HFP), E/Em(septal) >15. Age-, gender-, and LVEF-adjusted analyses were performed. LV volumes and LVEF were significantly different between the groups (P < 0.01). PWD-derived E-wave velocity showed a significant stepwise increase across the three groups and the Em(septal) velocity demonstrated a stepwise decrease (P < 0.01 for both). CMM-derived diastolic intra-ventricular pressure gradient (IVPG) was significantly lower in the HFP compared to the other 2 groups (P < 0.01 for both); Vp was increased in the HFP compared to the other 2 groups (P < 0.01 for both), and Vp exhibited a U-shape relationship to LVEF.
CONCLUSION: In patients with LVSD, abnormal LV relaxation is uniformly observed regardless of LV filling pressure. PWD-derived E-wave velocity and the TDI-derived Em velocity are important measurements to identify elevated LV filling pressures. CMM-derived Vp and IVPG were of limited incremental value for the evaluation of diastolic function in patients with LVSD.
Authors:
Aleksandr Rovner; Alan D Waggoner; Santhosh J Mathews; Víctor G Dávila-Román; Lisa de las Fuentes
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Echocardiography (Mount Kisco, N.Y.)     Volume:  24     ISSN:  0742-2822     ISO Abbreviation:  Echocardiography     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-25     Completed Date:  2007-08-29     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  8511187     Medline TA:  Echocardiography     Country:  United States    
Other Details:
Languages:  eng     Pagination:  478-84     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Analysis of Variance
Blood Flow Velocity
Diastole
Echocardiography, Doppler, Color*
Echocardiography, Doppler, Pulsed*
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Missouri
Mitral Valve / physiopathology,  ultrasonography
Research Design
Stroke Volume*
Systole
Ventricular Dysfunction, Left / physiopathology*,  ultrasonography*
Ventricular Pressure
Walking*
Grant Support
ID/Acronym/Agency:
K12RR023249/RR/NCRR NIH HHS; K24HL67002/HL/NHLBI NIH HHS; L30 HL074749/HL/NHLBI NIH HHS; L30 HL074749-03/HL/NHLBI NIH HHS; R01HL58878/HL/NHLBI NIH HHS; S10RR14778/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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